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Licensed Unlicensed Requires Authentication Published by De Gruyter June 2, 2018

Impact of a group-based treatment program on adipocytokines, oxidative status, inflammatory cytokines and arterial stiffness in obese children and adolescents

Jeerunda Santiprabhob, Kawewan Limprayoon, Prapun Aanpreung, Ratiya Charoensakdi, Ruchaneekorn W. Kalpravidh, Benjaluck Phonrat and Rungsunn Tungtrongchitr



Dysregulation of adipocytokines, inflammatory cytokines and oxidative stress are associated with the pathogenesis of obesity-related complications. This study aimed to evaluate the effect of a group-based lifestyle modification program on adipocytokines, inflammatory cytokines, oxidative status and arterial stiffness in obese youth.


A 1-year weight-reduction program was conducted. The program consisted of initial hospitalization and five outpatient group-based sessions held at 1, 2, 3, 6 and 9 months. Pre- and post-intervention measurements included anthropometric data, blood tests, body composition and brachial-ankle pulse wave velocity (ba-PWV).


A total of 126 obese youths were recruited, and 115 of those completed the study. Twenty-four participants had increased percentage weight for height at the end of the study (group A), 30 had minimal reduction (group B) and 61 had substantial reduction (group C). Lean mass significantly increased in all three groups (all p<0.001). A significant decrease in leptin (group A, p=0.021; group B, p=0.005; group C, p<0.001), interleukin-6 (IL-6) (group A, p=0.019; group B, p=0.004; group C, p<0.001) and ba-PWV (group A, p=0.031; group B, p=0.015; group C, p<0.001) was also observed. No significant change in the oxidative status was found among the groups. Reduction in ba-PWV was correlated with decreases in plasma malondialdehyde (pMDA) (r=0.233, p=0.036) and homeostasis model assessment of insulin resistance (HOMA-IR) (r=0.253, p=0.025).


A group-based healthy lifestyle program for obese youths had beneficial effects on adipocytokines, inflammatory cytokines and arterial stiffness. Participants without change in weight status also benefited. These improvements may reduce the risk of obese youths developing atherosclerosis.

Corresponding author: Jeerunda Santiprabhob, MD, Associate Professor, Division of Endocrinology and Metabolism, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi,Bangkok 10700, Thailand, Phone/Fax: +66-2-419-5676


The authors gratefully acknowledge the young people and their families who participated in this study. We would also like to thank Dr. Supawadee Likitmaskul, pediatric endocrinologist; Dr. Chanin Leewanun, rehabilitation physician; Mrs. Renu Wongarn, nutritionist; Ms. Pornpimol Kiattisakthavee, diabetes nurse; Ms. Praewvarin Weerakulwattana, researcher; Ms. Sunattra Nunloi, scientist; Mrs. Katharee Chaichanwattanakul, scientist; Ms. Amornrat Pipatsathiant, research assistant; and, Ms. Suwanee Weraviriyapitak, project coordinator for their invaluable support for this study. Finally, we would like to thank Ms. Atchara Suwannakin, rehabilitation nurse, for performing pulse wave velocity measurement, and Dr. Chulaluk Komoltri of the Department of Research and Development, Faculty of Medicine Siriraj Hospital for her assistance with statistical analysis.

  1. Author contributions: JS: Study conception and design, conducting the study, acquisition of data, analysis and interpretation of data, drafting of manuscript. KL, PA: Study conception and design, conducting the study, reviewing the manuscript, final approval of the manuscript. RC: Acquisition, analysis and interpretation of oxidative status data, reviewing the manuscript, final approval of the manuscript. RWK: Study conception and design, analysis and interpretation of oxidative status data, reviewing the manuscript, final approval of the manuscript. BP: Acquisition, analysis, and interpretation of adipocytokines and inflammatory cytokines data, reviewing the manuscript, final approval of the manuscript. RT: Study conception and design, acquisition, analysis and interpretation of adipocytokines and inflammatory cytokines data, reviewing the manuscript, final approval of the manuscript. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: This study was supported by the Siriraj Routine to Research Management Fund (grant no. R2R.031/07).

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


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Article note

This work was conducted at the Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University 2 Wanglang Road, Bangkoknoi, Bangkok 10700, Thailand. This work was presented at the 55th Annual European Society for Paediatric Endocrinology (ESPE) Meeting, 10–12 September 2016, Paris, France.

Received: 2018-01-09
Accepted: 2018-04-23
Published Online: 2018-06-02
Published in Print: 2018-07-26

©2018 Walter de Gruyter GmbH, Berlin/Boston

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